How to Become a Nurse and Career Pathways
There are multiple ways to become a nurse in the US and the process is not as complex as it might seem. If you’re interested in how to become a nurse (also known as a registered nurse or RN (RN) in the US, you should know that you have a choice of three main nursing pathways to follow. Your decision will depend on your circumstances, including your existing commitments, financial situation and as well as your nursing career goals.
The process of becoming a nurse can take anywhere from one to four years, with one year of study allowing you entry into the profession and three to four years permitting you to work as a registered nurse with increased responsibility and a higher earning potential from the outset. Here we’ll address the much-asked question of how to become a nurse with details on nursing requirements, the types of nursing qualifications available, and how many years it takes to become a nurse and the nursing careers open to you after your nursing school.
Requirements to be a Nurse
The requirements to be a nurse in the U.S. differ depending on the type of nurse you want to be. There are four professional titles and these are:
- Certified Nursing Assistant (CNA)
- Licensed Practical Nurse (LPN)
- Registered Nurse (RN)
- Advanced Practical Registered Nurse (APRN)
If you’re interested in becoming a registered nurse and gaining the license that allows you to work as an entry-level staff nurse, you’ll need to hold an associate’s degree in nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree.
To become an advanced practical registered nurse (APRN) you’ll also need to complete a specialized postgraduate degree in addition to the ADN or BSN. If you do not wish to study for a degree but still want to enter the nursing profession as soon as possible, you can become a CNA or become an LPN with completion of a short vocational course. These programs provide opportunities to progress into registered nursing roles with the right education and training.
If you have previously studied for a healthcare related degree and now wish to learn how to become a nurse and the steps to become a nurse, you can choose an accelerated baccalaureate nursing program which will take one and a half to two years to qualify for for the RN licensure exam.
State licensing for Nurses
How to become a registered nurse is not just a question of education, but also a question of gaining a US nurse license. Upon completion of your nursing degree or registered nurse (RN) training you will be eligible to sit the NCLEX-RN, which is the standardized exam issued by the National Council of State Nursing Boards and offered across the US. Only if you successfully pass this exam will you be able to gain state licensure and employment as a registered nurse (RN).
Watch a RN Career Video:
Before you think of gaining licensing however, you must first obtain the correct qualifications. To be eligible to take the RN licensure exam, you’ll need to hold a two- or four-year nursing degree, a three-year nursing diploma or the relevant RN qualification. Below, we’ve outlined each pathway of how to become a registered nurse in detail, including information on the curriculum and process.
Certified Nursing Assistant (CNA) and Licensed Practical Nurse (LPN) programs
CNA and LPN programs are two informal routes towards becoming a registered nurse for those who do not wish to gain their qualification with lengthy study at a college or university. The CNA and LPN qualifications are vocational courses offered at technical colleges, teaching hospitals, and community colleges. They can take 75 hours (CNA) to one year (LPN) respectively, leading to a certification exam. CNA and LPN programs provide theoretical classes and practical clinical training in either a hospital or clinic. Typical areas of study include first aid, nutrition, and physiology.
Watch a CNA Career Video:
These qualifications are not strictly guaranteed ways of becoming a registered nurse, but rather are the bare minimum requirements to enter into the profession. Because of this, you should keep in mind that until you undergo further on-the-job training, you’ll only be able to conduct basic nursing tasks such as administering injections, preparing patients for surgery, and changing dressings. Despite this, the CNA and LPN can be quick routes into the medical field, with some employers providing further training and tuition reimbursement for dedicated workers.
If you become an LPN and are still interested in becoming a registered nurse, consider enrolling on an LPN-RN program either at your place of work or at a community college or training hospital. This will allow you to progress in the nursing profession and use the credits you earned during your LPN training and put them towards your RN coursework.
Watch a LPN Career Video:
Associate’s Degree in Nursing (ADN/ASN)
An associate’s degree in nursing (ADN) offers a formal route into the nursing profession and takes two years to complete. Associate’s degrees in nursing are offered in community colleges, hospital-based schools of nursing, or training hospitals. A select few four-year colleges also offer this degree, aiming to provide the practical and technical training needed to work as a registered nurse in a certain area.
Applicants for the ADN must hold a high school diploma or GED and meet a specified grade point average, and some schools may even require nursing experience or a CNA qualification. Accepted degree titles for RN licensure include Associate of Applied Science in Nursing (AASN), Associate Degree in Nursing (ADN) or Associate of Science in Nursing (ASN).
Although on-site practical training is often a prerequisite, some programs now offer some of theoretical modules online, meaning that studying for an associate’s degree is more flexible than ever. Whether nursing classes online or on campus, an associate’s degree in nursing will blend theoretical coursework with hands-on training in labs and nursing clinics, commonly covering subject areas such as anatomy, biology, nutrition, and physiology.
Due to the growing employer preference for new nurses to hold a BSN, once you complete your ADN and become a registered nurse, you might think about enrolling on a RN-BSN conversion program. The RN-BSN program can be completed while you work as a nurse, meaning you can earn and gain invaluable experience all while advancing your qualifications and earning potential. Some employers even offer tuition reimbursement programs to help staff achieve their BSN qualification.
If you are looking to work as an RN for any length of time, pursuing the RN-BSN program is a wise choice, as not only does it open you up to career progression but it also is a necessity for anyone wanting to undertake further study at master’s or doctorate level in order to gain an advanced practical registered nurse (APRN) qualification.
Bachelor of Science in Nursing (BSN)
While you can also work as a registered nurse with an associate’s degree, with a four-year Bachelor of Science in Nursing (BSN) degree you’ll likely be hired for roles of more responsibility and therefore have a higher earning power. Also, in recent years, more and more US employers have been making the BSN a hiring requirement.
According to a 2012 nationwide survey of employers by the American Association of Colleges of Nursing (link opens in a new window), 43% of hospitals and healthcare providers in the US now require new nurses to hold a BSN, while 78% express a preference for BSN degree holders.
The Bachelor of Science in Nursing degree is a four-year program widely offered at recognized colleges and universities, with common requirements being a high school diploma or GED and a suggested grade point average, varying on the school. The BSN curriculum incorporates both theoretical coursework and clinical practice, covering scientific courses, nursing skill based courses, and general education requirements such as liberal arts subjects.
A typical BSN degree program will provide you with a rounded knowledge of the nursing profession, across all areas of healthcare. During your first two years you’ll be covering foundational units such as anatomy, biology, human growth and development, microbiology, nutrition, organic chemistry, psychology and physiology.
In your final two years there will be more freedom to specialize in your specific interests. Such as acute and chronic disease, community nursing, maternal health, mental health nursing, pediatrics, and public health. In addition to technical knowledge, you will also gain applied skills in leadership and assessment, as well as the ability to conduct your own evidence-based practice research across diverse fields such as economics, health informatics and health policy.
With this broad curriculum, the aim is to help students develop a deep understanding of the economic, cultural, political and social aspects that affect healthcare providers and their patients, giving students the practical and theoretical knowledge needed to deliver healthcare effectively in various environments.
Choosing a Nursing Program
If you are choosing a nursing program and not sure what nursing program you want to go into, a four-year BSN degree will give you a solid foundation across all possible areas, allowing you to gain a rounded knowledge of the profession with the chance to specialize later on in your studies.
Mature students, or those with work or family commitments, will often go down the route of obtaining a two-year associate’s degree or diploma due to the fact that these routes offer a shorter study period and more flexibility, with many colleges offering online or evening and weekend classes. If you don’t want to be out of work for any length of time to gain the education needed to become a nurse, you could consider on-the-job development by starting out as an CNA or LPN and then taking coursework to become an RN.
Advanced Practical Registered Nurse – Advanced Study
After successfully completing your BSN degree or RN-BSN qualification, you may wish to undertake further study in order to become eligible for advanced practical registered nurse (APRN) roles. With a BSN you are able to apply for a Master of Science in Nursing (MSN) and/or doctorate (PhD in Nursing) programs at colleges and universities across the US.
On a one- or two- year master’s degree, you are able to specialize further in an area of your choice, in topics such as administration, curriculum development, healthcare business practices, human resources, mental health, and nursing law.
PhD programs meanwhile are for students wishing to pursue upper-level careers in the nursing profession, such as chronic illness, global health, and women’s health. The PhD is a research based degree requiring a dissertation, but also both MSN and PhD programs will likely have a thesis as a required part of the course.
What can you do with a nursing degree?
Once you complete your nursing degree there are an endless amount of nursing careers open to you, across a range of diverse work environments. Before you try and answer the question of “what can you do with a nursing degree?” you should first ask yourself, “where do you want to work?”
Some common examples of where qualified nurses work include correctional facilities, home-based healthcare services, hospitals, local clinics, military bases, nursing homes, physicians’ offices, and schools.
Choosing from the wide selection of nursing careers will ultimately depend on you. you should think about the types of people you enjoy working with (i.e. the elderly or children), the type of environment you thrive in (i.e. in a home or a hospital), the shifts you want to work (i.e. night shifts, split shirts or normal-hour shifts) and the career progression you wish to see.
Career Satisfaction for Nurses
If you find value in serving and helping others, a career in nurse will provide high satisfaction. It is also a work environment that is non-competitive, meaning other nurses are your teammates and not trying to compete with one another in the workplace. In addition, this career can make people feel a sense of accomplishment and that their skills are put to good use.
Nurses are also in constant contact with others, so it goes without saying if a person is considering a career in nursing, they may want to consider whether they enjoy working with people or not.
Continued Career Research
If you do not have your degree in nursing yet, look at your areas job boards to see if some employers desire (or require) a bachelors in nursing or if an associates in nursing meets their need. Then, map out how to become a nurse from there. You could get a foot in the door as a nurse in as little as two years! You can learn more about a career in nursing from the American Nurses Association (link opens in a new tab).
Career Video Transcripts
Every hospital, clinic, and nursing home relies on a team of skilled staff to provide personal care to patients; nursing assistants and orderlies are an important part of that team. Under the supervision of nursing staff, nursing assistants provide basic care for patients, while orderlies transport patients and clean treatment areas.
Nursing assistants answer patient call signals, turn or reposition bedridden patients, and ensure each patient receives the appropriate diet. They help patients with daily living activities such as getting out of bed, using the bathroom, bathing, and walking. Nursing assistants measure vital signs, such as blood pressure and temperature. They observe and listen to patients’ health concerns, then document and share them with supervising nurses.
Orderlies move patients between bed and wheelchair or gurney, change bed linens, stock supplies, and clean facilities. Most nursing assistants work in nursing homes, hospitals, assisted living facilities, and in home health care. Most orderlies work in hospitals. Nursing assistants and orderlies typically work full time. Their work is physically demanding, with long hours spent on their feet and lifting and moving patients, so injuries are a risk. Work schedules that include nights, weekends, and holidays are common.
Nursing assistants must complete state-approved training, lasting from a few months to a year, then pass their state’s certification exam. Orderlies typically have at least a high school diploma or equivalent and receive on-the-job training.
With equal parts compassion and competence, licensed practical nurses and licensed vocational nurses, or LPNs and LVNs, play a crucial role in providing patient care. LPNs and LVNs help patients in nursing homes and other healthcare facilities, working under the direction of doctors and registered nurses, or RNs. LPNs and LVNs check patients’ vital signs, change dressings, and provide other types of basic patient care. They also help patients bathe and dress when needed.
Record keeping is an important aspect of the job, as is communicating patients’ concerns and questions to doctors and RNs. The exact duties of LPNs and LVNs vary by state, but their role on the front line of patient care doesn’t. Practical nursing takes patience and stamina. Attention to detail is essential in this career, as is being observant and communicating clearly. Licensed practical nurses and licensed vocational nurses work in nursing homes, hospitals, doctors’ offices, and in home healthcare. Becoming an LPN or LVN starts with completing a state-approved program, which usually lasts about 1 year. Licensure is required in all states.
Registered Nurse Transcript
Registered nurses, or RNs, are the largest healthcare occupation for good reason; they give patients medical care, educate them about their health issues, and offer emotional support. These medical professionals observe and record their patients’ condition. They help perform diagnostic tests to make effective plans for patient care.
Before patients head home from a treatment or procedure, RNs explain how to manage the illness or injury. A core part of medical teams, they consult with doctors and other health care professionals and may oversee the work of other nurses and assistants. Registered nurses work in hospitals, doctors’ offices, home health care services, and nursing homes. Some work in correctional facilities or schools, or serve in the military. Nurses may also have the opportunity to travel, as they are needed across the U.S. and around the world.
Risks, such as back injuries from lifting patients or exposure to infectious diseases and chemicals, are part of the job. They may work nights, weekends, and holidays, and be on call in off-hours. There are three paths to become an RN: a bachelor’s degree in nursing, an associate’s degree, or a diploma from an approved nursing program. They must also be licensed. Some nurses earn a master’s or doctoral-level degree and work in management, research, or academic settings. Combining competence with compassion, nursing is a career that improves, and even saves, many lives.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses.
National Center for O*NET Development. 29-2061.00. O*NET OnLine.
The career videos are in the public domain from the U. S. Department of Labor, Employment and Training Administration.